PubMed HealthSearch

Biomedical subjects

H Hertzeanu

Publications and source records attributed to H Hertzeanu.

10 recordsLinked to original sources

Exercise dependent complete left bundle branch block.

Eleven patients with an exercise dependent complete left bundle branch block (CLBBB) were followed-up over a period of 2-13 years (mean 6.5 +/- 3.8). Their ages ranged from 19 to 62 years (mean 48). Four patients complained of chest pain on effort and one of palpitations. All patients underwent a clinical examination, 12 lead ECG, routine blood tests, chest X-ray, a multistage exercise test, echo Doppler, radionuclide ventriculography with TC99 and 48-h Holter monitoring. Ten were submitted to a coronary angiography with left ventriculography. The ECG at rest displayed a normal ECG in seven patients and an incomplete left bundle branch block (ILBBB) in four patients. The onset heart rate (HR) of CLBBB ranged from 95-146 beats.min-1 (mean 123) and the offset HR75-135 (mean 102 beats.min-1). Coronary angiography showed three-vessel disease in two patients and an obstruction of the left anterior descending coronary artery (LAD) in the third. In the other seven patients all the investigations (including coronary angiography) were normal. During the follow-up period the HR at onset of CLBBB decreased from 145 beats.min-1 to 100 beats.min-1 in four patients but no coronary artery disease (CAD) could be proven at coronary angiography. In our series chest pain did not always signify the presence of CAD. We conclude, that in patients with exercise-dependent CLBBB the prognosis is good if no underlying heart disease can be detected. It appears from our limited experience that an exercise-dependent CLBBB at heart rate below 125 beats.min-1 does not by itself constitute a sign of CAD.

Bundle-Branch Block

Bopindolol and atenolol in patients with stable angina pectoris. Double-blind randomized comparative trial.

32 patients with stable angina and a positive symptom-limited exercise test (SLET) were investigated in a double-blind randomized trial in order to assess the therapeutic efficacy of bopindolol or atenolol on the incidence of angina pectoris and on angina pectoris threshold heart rate (ATHR). After a washout and placebo period of 2 weeks, each of the two drugs were applied in dosages of 0.5 mg bopindolol and 50 mg atenolol. The dosage was increased every month up to 2 mg bopindolol and 200 mg atenolol. At the end of every period, the patients were retested by SLET. After 3 months of active treatment, we noticed that the incidence of anginal attacks was lower in the bopindolol group (2.45 vs. 3.29). The resting heart rate was also lower in the bopindolol group (55.89 vs. 63.38). No statistical significance was found between the peak work rate, ATHR, exercise duration and S-T depression. The rate-pressure product was lower in the bopindolol group. We concluded from this that bopindolol and atenolol are active in decreasing the incidence of angina, the former being more effective. Exercise performance and cardiocirculatory parameters did not differ between the two groups.

Adrenergic beta-Antagonists

Holter monitoring in dizziness and syncope.

Holter monitoring was used to detect the underlying mechanism among 53 patients referred for dizziness, fainting and/or syncope. The complaints were unexplained on clinical grounds in 38, suggestive of SSS in 11, and of pacemaker dysfunction in 4 patients who underwent pacemaker implantation for symptomatic A-V block. Occult dysrhythmias were revealed in 24 of 38 (61%) of the first group; the clinical impression of SSS was confirmed in 8 of 11 (72%) in the second, and ineffective pacing confirmed in 2 of 4 in the third group. Thus, the diagnosis was clarified in 34 of 53 (64%) of patients. It is concluded that Holter monitoring is most useful for detecting the underlying mechanism in the above mentioned conditions, especially in elderly subjects whose syncopal attacks remained unexplained despite routine cardiological and neurological examination. Holter monitoring should be carried out for at least 36 hours before ruling out dysrhythmias as a cause of dizziness and/or syncopal attacks.

Adams-Stokes Syndrome

Left ventricular aneurysm of unusual aetiology: report of two cases.

Two young patients aged 14 and 25 with left ventricular aneurysms are described. In both, a clinical picture initiated by attacks of supraventricular tachycardia led to the discovery of the condition. In the first patient the clinical picture clearly suggested a traumatic aetiology. In the second, the angiographic and histological findings strongly favoured a congenital origin. Both patients underwent successful aneurysmectomy. The literature on the incidence and aetiology of traumatic or congenital ventricular aneurysms is discussed.

Adolescent